Abstract: Methods and instruments are disclosed for creating lesions in tissue, especially cardiac tissue, for treatment of arrhythmias and the like, by employing an elastic balloon and an energy emitter, which is independently positionable within the lumen of the instrument and adapted to project a series of spots of ablative energy through a transmissive region of the balloon to a target tissue site. The energy emitter preferably is configured such the spots of energy result in a series of lesions formed in the target tissue region when the emitter is activated, the lesions having an average area ranging from about 5 mm2 to about 100 mm2.

Abstract: A cardiac ablation instrument capable of removing blood from a treatment area is provided. The instrument includes a catheter configured to deliver a distal end thereof to a patient's heart. The instrument can also include an expandable element coupled to the distal end of the catheter wherein the expandable member is configured to be positioned adjacent a target area thereby defining a treatment area between the expandable member and the target area. Further, the instrument can include an irrigation mechanism configured to dispense an irrigation fluid from the catheter thereby displacing blood from the treatment area. Additionally, the instrument includes an energy emitter configured to deliver energy to tissue within the treatment area. The instrument can also include a contact sensor configured to determine the presence of such blood within the treatment area. Methods for ablating tissue are also provided.

Abstract: A cardiac ablation instrument capable of removing blood from a treatment area is provided. The instrument includes a catheter configured to deliver a distal end thereof to a patient's heart. The instrument can also include an expandable element coupled to the distal end of the catheter wherein the expandable member is configured to be positioned adjacent a target area thereby defining a treatment area between the expandable member and the target area. Further, the instrument can include an irrigation mechanism configured to dispense an irrigation fluid from the catheter thereby displacing blood from the treatment area. Additionally, the instrument includes an energy emitter configured to deliver energy to tissue within the treatment area. The instrument can also include a contact sensor configured to determine the presence of such blood within the treatment area. Methods for ablating tissue are also provided.

Abstract: Ablation methods and instruments are disclosed for creating lesions in tissue, especially cardiac tissue for treatment of arrhythmias and the like. Percutaneous ablation instruments in the form of coaxial catheter bodies are disclosed having at least one central lumen therein and having one or more balloon structures at the distal end region of the instrument. The instruments include an energy emitting element which is independently positionable within the lumen of the instrument and adapted to project radiant energy through a transmissive region of a projection balloon to a target tissue site to form a series of lesions on the target tissue.

Abstract: The present invention provides devices and methods for the treatment of atrial fibrillation. In one embodiment a deflectable sheath catheter includes an elongate catheter body having proximal and distal ends, the distal end having a distal tip region that includes a plurality of flexible segments with varying degrees of stiffness. A handle portion can be located at the proximal end of the catheter body to provide a steering mechanism that causes the distal tip region to deflect according to a compound curve.

Abstract: A method of treating atrial fibrillation includes the step of positioning a distal portion of an ablation instrument in proximity to one or more pulmonary veins. The instrument has a hollow housing and an independently axially positionable energy emitter within the distal portion The energy emitter is configured and the distal portion is shaped such that a distance a beam of ablative energy travels from the energy emitter to the portion of the distal portion in contact with target tissue changes based on the energy emitter's location along the length of the instrument while the distal portion maintains its shape The energy emitter is a light emitting element and a beam-forming optical waveguide that receives light from the light emitting element. The waveguide projects onto the distal portion a hollow cone of radiation.

Abstract: A cardiac ablation instrument capable of removing blood from a treatment area is provided. The instrument includes a catheter configured to deliver a distal end thereof to a patient's heart. The instrument can also include an expandable element coupled to the distal end of the catheter wherein the expandable member is configured to be positioned adjacent a target area thereby defining a treatment area between the expandable member and the target area. Further, the instrument can include an irrigation mechanism configured to dispense an irrigation fluid from the catheter thereby displacing blood from the treatment area. Additionally, the instrument includes an energy emitter configured to deliver energy to tissue within the treatment area. The instrument can also include a contact sensor configured to determine the presence of such blood within the treatment area. Methods for ablating tissue are also provided.

Abstract: The present invention provides devices and methods for the treatment of atrial fibrillation. In one embodiment a deflectable sheath catheter includes an elongate catheter body having proximal and distal ends, the distal end having a distal tip region that includes a plurality of flexible segments with varying degrees of stiffness. A handle portion can be located at the proximal end of the catheter body to provide a steering mechanism that causes the distal tip region to deflect according to a compound curve.

Abstract: A cardiac ablation instrument includes a catheter body and a tear-shaped balloon that is connected to the catheter body. The instrument further includes a radiant energy emitter that is axially movable within a central lumen of the catheter body. A radiant energy transparent body surrounds the energy emitter and includes a plurality of illumination fibers disposed circumferentially about the energy emitter. A detector communicates with a contact sensing element and is configured to determine an amount of at least one color component of the reflected light The amount of the at least one color component being indicative of contact between the balloon and a target tissue site.

Abstract: The present invention provides devices and methods for the treatment of atrial fibrillation. In one embodiment a deflectable sheath catheter includes an elongate catheter body having proximal and distal ends, the distal end having a distal tip region that includes a plurality of flexible segments with varying degrees of stiffness. A handle portion can be located at the proximal end of the catheter body to provide a steering mechanism that causes the distal tip region to deflect according to a compound curve.

Abstract: Methods and instruments are disclosed for creating lesions in tissue, especially cardiac tissue, for treatment of arrhythmias and the like, by employing an elastic balloon and an energy emitter, which is independently positionable within the lumen of the instrument and adapted to project a series of spots of ablative energy through a transmissive region of the balloon to a target tissue site. The energy emitter preferably is configured such the spots of energy result in a series of lesions formed in the target tissue region when the emitter is activated, the lesions having an average area ranging from about 5 mm2 to about 100 mm2.

Abstract: The present invention provides devices and methods for the treatment of atrial fibrillation. In one embodiment, a deflectable sheath catheter includes an elongate catheter body having proximal and distal ends, a deflectable end section at the distal end of the catheter body, which upon deflection causes the distal end segment to bend into various curved positions within a plane of deflection, and a bent tip oriented in a direction that is out of the plane of deflection.

Abstract: A cardiac ablation instrument capable of removing blood from a treatment area is provided. The instrument includes a catheter configured to deliver a distal end thereof to a patient's heart. The instrument can also include an expandable element coupled to the distal end of the catheter wherein the expandable member is configured to be positioned adjacent a target area thereby defining a treatment area between the expandable member and the target area. Further, the instrument can include an irrigation mechanism configured to dispense an irrigation fluid from the catheter thereby displacing blood from the treatment area. Additionally, the instrument includes an energy emitter configured to deliver energy to tissue within the treatment area. The instrument can also include a contact sensor configured to determine the presence of such blood within the treatment area. Methods for ablating tissue are also provided.

Abstract: The present invention is directed to an anchoring balloon structure for use with catheters. The anchoring balloon structure contains an expandable balloon disposed about a port on a catheter, and a pressure-relief valve for regulating the pressure in the balloon and for providing irrigation to a body lumen. The pressure-relief valve is located external to the expandable balloon. The balloon, when filled with fluid, expands and is engaged in direct contact with the tissue. The increase in pressure caused by the balloon against the tissue causes any additional fluid to migrate into the valve region, whereby excess pressure is released and irrigation is provided to the body lumen.

Abstract: Ablation methods and instruments are disclosed for creating lesions in tissue, especially cardiac tissue for treatment of arrhythmias and the like. Percutaneous ablation instruments in the form of coaxial catheter bodies are disclosed having at least one central lumen therein and having one or more balloon structures at the distal end region of the instrument. The instruments include an energy emitting element which is independently positionable within the lumen of the instrument and adapted to project radiant energy through a transmissive region of a projection balloon to a target tissue site. The instrument can optionally include at least one expandable anchor balloon disposed about, or incorporated into an inner catheter body designed to be slid over a guidewire. This anchor balloon can serve to position the device within a lumen, such as a pulmonary vein.

Abstract: The present invention is directed to a balloon catheter having an irrigation sheath. The balloon catheter has a first expandable membrane forming an occluding balloon. A second membrane forms a sheath about the occluding balloon for providing irrigation to a body lumen. Fluid is provided to the occluding balloon to position the catheter and/or occlude the flow of blood. Fluid is then passed through the sheath to irrigate the target site. In one embodiment of the present invention, the sheath has a plurality of fluid releasing pores.

Abstract: Methods and apparatus are disclosed for forming annular lesions in tissue. The methods include introduction of an optical apparatus proximate to a tissue site, via, for example, a catheter. The optical apparatus includes a pattern-forming optical waveguide in communication with a light transmitting optical fiber. Energy is transmitted through the optical fiber, such that radiation is propagated through the optical fiber and the waveguide projects an annular light pattern, e.g., a circle or a halo.

Abstract: The present invention is directed to a hand held cardiac ablation instrument and methods for irradiating a target ablation site. The instrument can include at least one light transmitting optical fiber and a light diffusing element to create a circumferential or curvilinear lesion. A handle is provided for manual application. The handle can be substantially coaxial or otherwise aligned with the center of the circumferential housing. Light travelling through the light transmitting optical fiber or fibers is scattered in a circular pattern by the light diffusing element. The light diffusing element can include a scattering medium, a reflective end cap, and a reflective surface diametrically opposed to the target ablation site, that interact to provide a substantially uniform distribution of laser radiation throughout the circular target region.

Abstract: A phototherapy device which can include an optical fiber having a perfluorinated polymer outer buffer coating, and an optical element, such as a GRIN lens or a mirror, disposed at its distal end. A tubular housing encases the optical element and is thermally bonded to at least a portion of the buffer. The component elements of the device can be constructed of materials having similar thermal characteristic to inhibit the effect of heat cycling on the device. In addition, the materials of the device, and in particular the housing, can be selected to inhibit wear and scrapping of the lumen of the delivery instrument during use. A marker band can be positioned about the optical fiber to facilitate viewing of the phototherapy device in-vivo.

Abstract: A low-profile, diffusive tip apparatus adapted for insertion into a body to deliver phototherapeutic radiation by scattering light in a substantially omnidirectional pattern includes a light-transmissive housing that is adapted for mounting, at its proximal end, onto a fiber optic cable, and, at its distal end, the housing defines or is joined to a light-transmissive cap having a diameter which is not substantially greater than the diameter of the optical fiber. The light transmissive cap region encloses a chamber or reservoir filled with an optically scattering medium and, preferably, hemispherical in shape with a radius of curvature substantially equal to the radius of the housing.